OTC Flashcards
What is Constipation
Decrease in bowel motility due to infrequent stool s or difficulty passings stools
Symptoms of Constipation
Bloated, Abdominal discomfort/distention
Disease induced (Consitipation)
Irritable bowel syndrome, Thyroid dysfunction, Crohn’s disease
Exclusions for self-treatment of Constipation
- Previous appropriate self-care does not resolve symptoms
- Blood in stool
- Vomiting
-Fever - Abdominal pain
- Symptoms persisting >1 week
-Recent Weight loss
MOA of Bulk-forming Laxatives
pull fluid into stool (initial treatment for simple constipation)
3 Drugs of Bulk-forming Laxatives
Methylcellulose(Citrucel), Calcium polycarbophil(Fibercon), Psyllium (Metamucil)
The brand name of Methylcellulose
Citrucel
The brand name of Calcium polycarbophil
Fibercon
The brand name of Psyllium
Metamucil
MOA of Emollient Laxatives
increases the softening of stool (Agents help to prevent constipation by relieving hard, dry stool)
Adverse effects of Emollient Laxatives
Diarrhea, abdominal cramping
Onset action of Emollient Laxatives
24-72 hours
1 drug of Emollient Laxatives
Docusate sodium
The brand name of Docusate sodium
Colace
Dosing of Docusate sodium
Children > 6 years: 100mg PO daily
Adults : Up to 100 mg PO tid
MOA of Lubricant Laxatives
softens and coats for a “slippery stool”
Adverse Effects of Lubricant Laxatives
Abdominal cramping, diarrhea, nausea, vomiting
Onset of action of Lubricant Laxatives
8 hours
1 drug of Lubricant Laxatives
Mineral oil
Dosing of Mineral Oil
Children 6-11 yrs : 10-25mL PO per day
Adults : 15-45 mL PO per day
Recommendation of Mineral Oil
for patients who need to avoid straining
Exceptions of Mineral Oil
- Very young patients
- Advanced age
-Debilitated patients - Not a good recommendation due to lower absorption of fat soluble vitamins
- Caution : sit upright when taking medications due to risk of aspirating mineral oil into lung (liquid pneumonia)
MOA of Hyperosmotic Laxatives
draws water into the colon and provides local irritation to prompt bowel evacuation
Adverse effect of Hyperosmotic Laxatives
stomach discomfort, bloating
onset of action
varies per product
two drugs of Hyperosmotic Laxatives
Glycerin Suppository, Polyethylene Glycol
Brand name of Glycerin suppository
Fleet Glycerin suppositroy
dosing of Glycerin suppository
- Children < 6 years : 1 infant suppository rectally 1-2 times per day as needed
- Adults : 1 suppository rectally 1-2 times per day as needed
Onset of Action of Glycerin suppository
within 30 min
Brand name of Polyethylene Glycol
Miralax
Dosing of Polyethylene Glycol
- Adults : 17 grams (1 capful) in 4-8 ounces of liquid PO once daily
- May need to titrate dose
- should not be used > 1week without consulting physician
onset of action of Polyethylene Glycol
2 hours to 4 days
MOA of Stimulant Laxatives
increase peristaltic movement throughout the gut by mucosal irritation
Adverse Effects of Stimulant Laxatives
abdominal cramping, diarrhea, nausea, vomiting
onset of action of Stimulant Laxatives
6-10 hrs
Cautions of Stimulant Laxatives
avoid use > 1 week
avoid in patient with constipation due to hard stool
2 drugs of Stimulant Laxatives
Bisacodyl (Dulcolax), Sennosides ( Senna)
Brand name of Bisacodyl
Ducolax
Brand name of Sennacide
Senna
Dosing of Bisacodyl
-Children 6-11 yrs : 5-10 mg PO per day (maximum)
-Adults : 5-15 mg PO per day
Dosing of Sennosides
Children 6-12 yrs : 8.6 mg PO per day
- Adults: 17.2 mg PO bid
- Max of 4 tablets (34.4mg) PO bid
what’s diarrhea
an increase in the patients normal number of bowel movements per day or decrease in consistency of the stool
types of Diarrhea
Acute : lasting a few days to a week
Chronic : lasting > three weeks
Goals of Treatment of Diarrhea
- Prevent dehydration
- Decrease frequency and increase formation of stools
- Identify cause
Exclusions for self-treatment
- Fever > 101 F
- Blood present in stool
- Severe diarrhea with no signs of improvement in 48 hrs
- Severe dehydration
- Pregnancy
- During/following a course of antibiotics
- immediately following travel from a foreign country
2 drugs of Diarrhea
Loperamide, pepto-bismol
2 brand names of Loperamide
Imodium, Maalox anti-diarrheal caplets
MOA of Loperamide
acts on the opioid receptor to decrease motility allowing for more absorption through the intestines
Dosing of Loperamide
Children 6-8 yrs : 1 caplet PO with first loose stool, then 1/2 caplet with each subsequent loose stool
- Max 2 caplets per 24 hrs
Children 9-11 yrs : 1 caplet PO with first loose stool, then 1/2 caplet with each subsequent loose stool
- Max 3 caplets per 24 hrs
Adults > 12 yrs : 2 caplets PO with first loose stool, then 1 caplet with each subsequent loose stool
- Max 4 caplets per 24 hrs
Adverse Effect of Loperamide
Constipation, abdominal cramping